Document Detail

Calf muscle perfusion at peak exercise in peripheral arterial disease: measurement by first-pass contrast-enhanced magnetic resonance imaging.
MedLine Citation:
PMID:  17410566     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To develop a contrast-enhanced magnetic resonance (MR) technique to measure skeletal muscle perfusion in peripheral arterial disease (PAD).
MATERIALS AND METHODS: A total of 11 patients (age = 61 +/- 11 years) with mild to moderate symptomatic PAD (ankle-brachial index [ABI] = 0.75 +/- 0.08) and 22 normals were studied using an MR-compatible ergometer. PAD and normal(max) (Nl(max); N = 11) exercised to exhaustion. Nl(low) (N = 11) exercised to the same workload achieved by PAD. At peak exercise, 0.1 mm/kg of gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) was infused at 3-4 cm(3)/second followed by a saline flush at the same rate. A dual-contrast gradient echo (GRE) sequence enabled simultaneous acquisition of muscle perfusion and arterial input function (AIF). The perfusion index (PI) was defined as the slope of the time-intensity curve (TIC) in muscle divided by the arterial TIC slope.
RESULTS: Median workload was 120 Joules in PAD, 210 Joules in Nl(low), and 698 Joules in Nl(max) (P < 0.001 vs. Nl(low) and PAD). Median PI was 0.29 in PAD (25th and 75th percentiles [%] = 0.20, 0.40), 0.48 in Nl(low) (25th, 75th % = 0.36, 0.62; P < 0.02 vs. PAD), and 0.69 in Nl(max) (25th, 75th % = 0.5, 0.77; P < 0.001 vs. PAD). Area under the ROC-curve for PI differentiating patients from Nl(max) was 0.95 (95% confidence interval [CI] = 0.77-0.99).
CONCLUSION: Peak-exercise measurement of lower limb perfusion with dual-contrast, first-pass MR distinguishes PAD from normals. This method may be useful in the study of novel therapies for PAD.
David C Isbell; Frederick H Epstein; Xiaodong Zhong; Joseph M DiMaria; Stuart S Berr; Craig H Meyer; Walter J Rogers; Nancy L Harthun; Klaus D Hagspiel; Arthur Weltman; Christopher M Kramer
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of magnetic resonance imaging : JMRI     Volume:  25     ISSN:  1053-1807     ISO Abbreviation:  J Magn Reson Imaging     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-30     Completed Date:  2007-06-28     Revised Date:  2014-09-18    
Medline Journal Info:
Nlm Unique ID:  9105850     Medline TA:  J Magn Reson Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1013-20     Citation Subset:  IM    
Copyright Information:
(c) 2007 Wiley-Liss, Inc.
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MeSH Terms
Aged, 80 and over
Case-Control Studies
Contrast Media
Gadolinium DTPA / diagnostic use
Image Processing, Computer-Assisted
Intermittent Claudication / physiopathology*
Leg / blood supply
Linear Models
Magnetic Resonance Imaging / methods*
Middle Aged
Muscle, Skeletal / blood supply*
ROC Curve
Statistics, Nonparametric
Grant Support
Reg. No./Substance:
0/Contrast Media; K2I13DR72L/Gadolinium DTPA

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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